“Angiographic late catch-up” phenomenon after sirolimus-eluting stent implantation

• Published in: International journal of cardiology 2012-09, Vol.160 (1), p.48-52
• Main Authors: Yang, Tae-Hyun, Kim, Doo-Il, Jin, Han-Young, Cho, Young-Wan, Chung, Sang Ryul, Kim, Dong-Kie, Kim, Yong-Bok, Jang, Jae-Sik, Kim, Ung, Seol, Sang-Hoon, Kim, Dae-Kyeong, Kim, Dong-Soo
• Format: Article
• Language: English
• Subjects: Angiography; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Cardiovascular system; Coronary Aneurysm - diagnostic imaging; Coronary Aneurysm - etiology; Coronary Angiography; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - etiology; Coronary Vessels - pathology; Drug-Eluting Stents - adverse effects; Female; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Pharmacology. Drug treatments; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Sirolimus; Sirolimus - adverse effects; Sirolimus - therapeutic use; Stents
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2011.03.024

Abstract Background Although several randomized trials have shown that sirolimus-eluting stent (SES) substantially reduces in-stent restenosis, recent studies have suggested the possibility of late catch-up after SES implantation. We investigated long-term angiographic outcomes after SES implantation in real-world practice. Methods This study was conducted on 195 patients with 253 lesions who underwent the first and long-term angiographic follow-up after SES implantation. First follow-up was done at near 6 months after SES implantation. Long-term angiographic follow-up was defined as that performed at least 36 months after index procedure. Angiographies in patients who experienced target lesion revascularization at the time of the first angiographic follow-up were excluded from the current analysis. Results Minimal luminal diameter at long-term angiographic follow-up was significantly smaller compared with that at the first follow-up (2.21 ± 0.65 vs. 2.40 ± 0.55, p < 0.001). In-stent late lumen loss between the first and long-term follow-up tended to be larger compared with that between SES implantation and the first follow-up (0.19 ± 0.47 vs. 0.15 ± 0.39, p = 0.298). There was a trend for increased incidence of coronary artery aneurysm (1.6% and 7.5% at the first and long-term follow-up) and stent fracture (4.3% and 10.3%). Two stent aneurysms and one stent fracture were related with definite very late stent thrombosis. Conclusion An “angiographic late catch-up” phenomenon and a trend toward increased incidence of coronary artery aneurysm and stent fracture were found at a median 46.5-month angiographic follow-up compared with a median 6-month follow-up.